The Billing Director oversees all revenue cycle functions for the Clinics and Ambulatory Surgery Center, ensuring accurate, compliant, and timely reimbursement. They manage the billing team in multiple locations (2), handle complex denials, and optimize workflows for insurance, manages billing contracts and provider credentialing. This role requires expertise in medical coding, high-level reporting, and financial auditing and is a part of the executive team.
Core Responsibilities
- Revenue Cycle Management: Oversee the entire billing process, including but not limited to; charge entry, claims submission, payment posting , denials management, appeals, fee schedule management, time-of-service policy and collections.
- Accounts Receivable (A/R) Management: Analyze and resolve denied claims, manage accounts receivable (AR) aging, and reduce days in A/R. Monitor accounts receivable and implement strategies to improve reimbursement and reduce denials.
- Coding Compliance: Ensure accuracy of CPT, ICD-10, HCPCS codes (specializing in Ophthalmology procedures, procedures like cataract surgery and injections, and maintain compliance with Medicare guidelines.
- Team Leadership: Supervise, train, and mentor billing specialists and staff.Create key performance indicators for each position in the billing department and forecast upcoming needs and changes within the department.
- Reporting: Generate financial reports on key performance indicators (KPIs) for ownership or management. Study trends and report to management periodically.
- System Administration: Maintain the Electronic Health Record (EHR) and billing software. Provide first level of contact with clearinghouse agencies.
- Payer Relations/ Contract Relations: Handle credentialing issues and communicate with insurance payers to resolve reimbursement discrepancies. Establish and maintain contracts with medical payers.
- Charge Capture: Review documentation to ensure proper charge capture for services rendered.
Key Requirements
- Experience: Minimum 3–5+ years of medical billing experience, with a focus on Ophthalmology or medical practice.
· Education: Certificated Professional Coder (CPC), Certified Coding Specialist (CCS), or business or accounting degree.
- Knowledge: Comprehensive understanding of Medicare, Medicaid, and private payer rules, particularly for Ophthalmic services.
- Software: Proficiency in Practice Management Systems (PMS) and Electronic Health Record (EHR) software.
- Skills: Strong leadership, communication, analytical, and organizational skills.
Pay: $31.73 - $36.00 per hour
Benefits:
- 401(k) matching
- Dental insurance
- Employee discount
- Health insurance
- Paid time off
- Retirement plan
Work Location: In person
